Background: The diagnosis of oral cavity cancers and treatments/ disease related distress from the oral–facial areas may influencepatients’ quality of life (QOL). The purposes of this study were to(1) examine the changes of symptoms (physical distress), psycholog -ical distress (depression and anxiety) and QOL during the first12 month s of being diagnosed as oral cavity cancer, (2) identify fac- tors related to overall QOL, and (3) identify QOL sub-patt erns innewly diagnosed oral cavity cancer patients in Taiwan.

Materials and methods: A 12-mont h prospective longitudinal study was conduc ted to assess the changes of sympt om, psycholog ical dis- tress and QOL. Subjects were recruite d from three medical centers inNorthern Taiwan and were assessed on 6 time points (days before operation , 1, 2, 3, 6 12 months post surgery/T1–T6, respect ively).The psychomet rically validated Chinese version instrument s were used, includin g (1) Symptom Severity Scale (SSS), (2) Hospit al Anxi- ety and Depression Scale (HADS), (3) Universit y of Washing ton Qual- ity of Life (UW-QOL), and (4) Backgroun d Informat ion Form. Inaddition to the descriptive statistics, the Generali zed Estimating Equations (GEE) was applied to identify the overall QOL related fac- tors. The latent class growth modeling was used to identify the potential QOL sub-patterns . Data were collected after Institute Review Board (IRB) approval and patients’ consents.

Results: A total of 150 eligible subjects completed the 12 month sassessment s. Overall, patien ts reported moderate levels of QOL with the worst QOL during the first three months post-surgery (T2–T4).However, some delayed problems were also reported, includi ngdry mouth, swallowing problem, chewing dysfunction and employ- ment concern . Patients having reconstruct ion surgery, more advanced cancer stage, higher levels of depression and symptom severity, without job, and having lower educatio n level were found to have lower levels of QOL across the time. QOL sub-pattern s were also identified.

Conclusion: Results of the study provide the evidence -based infor- mation to health care professionals to better help oral cavity cancer patients with timely interventio ns. Future studies should also test the effects of these interventio ns on improvin g patients’ QOL.

doi:10.1016/j.oraloncolo gy.2013.03.077

OP070

Emergen t trends of perceive d needs and concerns in long-term survivors of head and neck cancer using the patients concerns inventor yNaseem Ghazali, Brenda Roe, Derek Lowe, Simon N. Rogers

Regional Maxillofaci al Unit, University Hospital Aintree , Liverpool, UK

Objectives: The Patients Concerns Inventor y (PCI) is a holistic needs assessmen t tool to help patients disclose items of concer nduring routine clinical consultat ions. The Universit y of Washing ton Quality of Life (UWQOL) is a validated, HNC-spe cific HRQOL,which can also screen for patients with significant problems. This study explored associat ions between PCI outcomes with UWQOL scores.

Methods: A cross-sec tional study of 674 HNC patients (mean age 64 years; 67% men) who completed the HNC-PCI and UWQOL was undertak en. Relationsh ips between HNC-PCI domain selection,UWQOL scores and patient/cl inical characterist ics were investig ated,with statistical significance obtained as appropriat e.

Results: Most (70%, 472) completed HNC-PCI only once (median,39 months), while 30% (202) completed more than once. On firstcompleti ng the HNC-PCI (median, 32 months from surgery/dia gno- sis), items under Physical and functional and Psychologi cal and Emo- tional well-being /Spiritual domains were selected in 81% and 58%,respect ively. When completin g a second HNC-PCI, relativel y fewer items per domain. Younger patien ts and those treated by radiother- apy were more likely to select from Psycho logical and Emotional well-bei ng/Spiritual and Social care/Socia l well-being domains.Those treated by adjuvant radiotherap y and the larynx subsit e were more likely to select from Social care/Socia l well-bei ng domain. Clear associat ions were found between four HNC-PCI domains selected with UWQOL subscale scores, and also with the single item UWQOL and overall QOL, where patients in worse condition were more likely to select items within each HNC-PCI domains.

Conclusions : Emergin g trends suggest that certain clinical-pat ho- logical factors are associated with specific presentati on of perceived needs/co ncerns. The association between perceiv ed needs with HRQOL outcomes endorses the importan ce of meeting unmet needs in long-term HNC survivors even though there is a suggest ion that the unmet needs may reduce with time.

doi:10.1016/j.oraloncology.2013.03.078

OP071

Decisio n making scrutinized : Partici pant observati on of HNO- patient sChiquit van Linden van den Heuvell a, Geert van der Laan a,Anke Korfage a, Grieteke Pool b, Jan Roodenbur g a

a Departme nt of Oral Maxillofaci al Surgery and Special Dental Care,Univers ity Medical Center Groningen, Groningen, The Netherlands b Department of Health Sciences, University Medical Center Groningen,Groninge n, The Netherla nds

Background : The concept of decision making can be divided in two aspects: problem solving and decision making itself (Deber et al.,1996, Arch Int Med 156 [8]).

Problem solving tasks are related to medical facts and require expertise . They belong to the specialist s, who must identify the availabl e alternatives .

But identifyi ng the alternati ves does not dictate what should bedone or what value a patient will place on a particular outcome.Decision making about what one wishes to be done is ultimately the patient’s job.

Furthermore, when you confront patients with both elements,they seem to prefer being guided by the physician (Deber et al.,1996). So one might get the impression that patients don’t want toparticip ate in decision making, while actually they are reacting toproblem solving aspects.

Our research aims to provide insight in the way ‘‘shared decisio nmaking’’ is put into practice.

Method: In a qualitati ve observat ional research patien ts are observed from their first office visits until the start of treatment .The observer is present with an annou nced but invisible camera,withou t any interferenc e of the consultation hour.

Results: There seems to be a confoundin g of problem solving- and decisio n making aspects in counselin g the patien t. The emphasis inthe decision making process currently seems to favour problem

S32 Abstracts / Oral Oncology 49 (2013) S4–S79